The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Data Collection
2.3. Questionnaire Design
- (1)
- General information of the participants, including age, gender, body weight (kg), height (cm), waist circumference (cm), body mass index (BMI, kg/m2), smoking status, and alcohol drinking status. BMI was categorized into four groups using the Asian BMI classification: underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), and obese (≥25 kg/m2) [18].
- (2)
- Information on work tasks, including work experience (years), working hours (h/day), shift work, and job tasks.
- (3)
- Prior cardiopulmonary problems, such as myocardial infarction, arrythmia, asthma, and stroke.
2.4. Cardiopulmonary Fitness Assessment
- (1)
- Spirometry, chest X-ray (CXR), and electrocardiogram (EKG) were performed for the participants. The spirometry test was assessed using the SpiroMaster PC-10. The procedures were performed and required at least three acceptable graphs, following the ATS/ERS standards [19]. Various parameters, including FEV1, FCV, and FEV1/FCV, were collected. The Thai Siriraj equation [20] was used as the predicted value reference.
- (2)
- Metabolic equivalents are defined as caloric consumption during an activity. One MET means caloric consumption at rest. They are used as an estimate of functional capacity, with greater METs indicating that more energy is consumed during an activity. To estimate METs for physical activities performed at work, a face-to-face interview using the global physical activity questionnaire (GPAQ) was utilized [21]. The participants were asked about their “intensity and duration” of physical activity at work and in transportation. Using the GPAQ data, the following MET values were used to determine a person’s overall energy expenditure: four METs for moderate activity and eight METs for vigorous activity. The data were analyzed as MET minutes per week based on the intensity of physical activity and duration of activity in minutes per week. We categorized the MET groups as eight METs (19,200 MET minutes per week) and twelve METs (28,800 MET minutes per week) according to the requirements in the guidance of NFPA. The calculation was based on the assumption of 8 working hours in 5 days a week.
- (3)
- The Thai CV risk score was used to estimate the 10-year incidence prediction of cardiovascular disease [22]. The parameters included age, sex, height, blood pressure, smoking status, diabetes history, and waist circumference. The researcher measured each participant’s waist circumference. The risks of over 10% were categorized as intermediate risks.
2.5. Definition of Fitness Level
2.6. Statistical Analysis
3. Results
Cardiopulmonary Fitness
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Evaluation of Electrocardiogram and Chest X-ray to Classify Medical Conditions with Work Restrictions
Category A | Category B | |
Electrocardiogram If EKG shows any clue to the following list |
|
|
Chest X-ray If CXR shows any clue to the following list |
|
|
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Characteristics | Total (N = 62) | Fit (n = 8) | Job Restriction (n = 54) | p-Value |
---|---|---|---|---|
N (%) | n (%) | n (%) | ||
Sex | 0.656 a | |||
Male | 59 (95.16) | 8 (100) | 51 (94.44) | |
Female | 3 (4.84) | 0 | 3 (5.56) | |
Age (year), mean (SD) | 41.66 (10.42) | 42.63 (6.76) | 41.52 (10.90) | 0.700 b |
Weight (kg), mean (SD) | 67.39 (9.86) | 67.63 (5.45) | 67.35 (10.39) | 0.911 b |
Height (cm), mean (SD) | 166.24 (6.91) | 166.88 (5.22) | 166.15 (7.16) | 0.731 b |
Waist circumference (cm), mean (SD) | 34.75 (3.42) | 36.10 (2.32) | 34.55 (3.53) | 0.129 b |
Work experience (year), mean (SD) | 13.23 (9.97) | 16 (8.09) | 12.82 (10.22) | 0.348 b |
BMI (kg/m2), mean (SD) | 24.30 (3.06) | 24.30 (1.73) | 24.30 (3.22) | 0.996 b |
BMI categories | 1.000 a | |||
Underweight | 1 (1.61) | 0 | 1 (1.85) | |
Normal | 18 (29.03) | 2 (25.00) | 16 (29.63) | |
Overweight | 22 (35.48) | 3 (37.50) | 19 (35.19) | |
Obese | 21 (33.87) | 3 (37.50) | 18 (33.33) | |
Shift work | 0.620 a | |||
Yes | 45 (72.58) | 6 (75.00) | 39 (72.22) | |
No | 17 (27.42) | 2 (25.00) | 15 (27.78) | |
Smoke | 0.712 a | |||
Active smoker | 26 (41.94) | 4 (50.00) | 22 (40.74) | |
Ex-smoker | 20 (32.26) | 3 (37.50) | 17 (31.48) | |
Non-smoker | 16 (25.81) | 1 (12.50) | 15 (27.78) | |
Alcohol | 0.403 a | |||
Regular drinking | 32 (51.61) | 3 (37.50) | 29 (53.70) | |
Social drinking | 16 (25.81) | 4 (50.00) | 12 (22.22) | |
Ex-drinking | 5 (8.06) | 0 | 5 (9.26) | |
Non-drinking | 9 (14.52) | 1 (12.50) | 8 (14.81) |
Cardiopulmonary Parameters | Total (N = 62) | Fit (n = 8) | Job Restriction (n = 54) | p-Value |
---|---|---|---|---|
mean (SD) | mean (SD) | mean (SD) | ||
METs (minutes per week) | 7333.55 (8755.27) | 24,240 (5940) (median, (IQR)) | 4640 (5241.20) | <0.001 a |
METs | <0.001 b | |||
MET > 12 | 2 (3.22) | 2 (25.00) | 0 | |
MET 8–12 | 6 (9.68) | 6 (75.00) | 0 | |
MET < 8 | 54 (87.10) | 0 | 54 (100) | |
CV risk in 10 years (%) | 4.53 (3.54) | 2.51 (2.33) (median, (IQR)) | 4.68 (3.66) | 0.629 a |
CV risk classification (n, %) | 1.00 b | |||
Low risk | 57 (91.93) | 8 (100) | 49 (90.74) | |
Intermediate risk | 5 (8.07) | 0 | 5 (9.26) | |
Resting heart rate (bpm) | 88.48 (13.51) | 88 (11.03) | 88.56 (13.92) | 0.901 c |
BMI (kg/m2) | 24.30 (3.06) | 24.30 (1.73) | 24.30 (3.22) | 0.996 c |
SBP (mmHg) | 134.35 (15.87) | 128.63 (10.35) | 135.20 (16.43) | 0.231 c |
DBP (mmHg) | 76.58 (10.80) | 76.75 (8.36) | 76.56 (11.18) | 0.875 c |
Pulmonary function * | ||||
FEV1 (mL) | 3425.54 (811.37) | 3316.25 (495.58) | 3443.75 (855.24) | 0.805 c |
FVC (mL) | 4171.79 (939.73) | 4116.25 (604.69) | 4181.04 (989.11) | 0.561 c |
Pulmonary function result * (n, %) | 1.000 b | |||
Normal | 51 (91.07) | 8 (100) | 43 (89.58) | |
Obstruction | 4 (7.14) | 0 | 4 (8.34) | |
Restriction | 1 (1.79) | 0 | 1 (2.08) | |
Underlying disease (n, %) | ||||
None | 53 (85.48) | 7 (87.50) | 46 (85.19) | |
Myocardial infarction | 1 (1.61) | 0 | 1 (1.85) | 1.000 b |
Arrhythmia | 2 (3.23) | 0 | 2 (3.70) | 1.000 b |
Asthma | 4 (6.45) | 1 (12.50) | 3 (5.56) | 0.433 b |
Stroke | 2 (3.23) | 0 | 2 (3.70) | 1.000 b |
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Panumasvivat, J.; Sirikul, W.; Surawattanasakul, V.; Wangsan, K.; Assavanopakun, P. The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand. Int. J. Environ. Res. Public Health 2023, 20, 3527. https://doi.org/10.3390/ijerph20043527
Panumasvivat J, Sirikul W, Surawattanasakul V, Wangsan K, Assavanopakun P. The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand. International Journal of Environmental Research and Public Health. 2023; 20(4):3527. https://doi.org/10.3390/ijerph20043527
Chicago/Turabian StylePanumasvivat, Jinjuta, Wachiranun Sirikul, Vithawat Surawattanasakul, Kampanat Wangsan, and Pheerasak Assavanopakun. 2023. "The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand" International Journal of Environmental Research and Public Health 20, no. 4: 3527. https://doi.org/10.3390/ijerph20043527